Digestive Diseases and Sciences

, Volume 46, Issue 10, pp 2250–2255

Jejunal Manometry Predicts Tube Feeding Intolerance in the Postoperative Period

  • Brent W. Miedema
  • Jeffrey Schwab
  • Scott V. Burgess
  • James W. Simmons
  • Michael H. Metzler
Article

DOI: 10.1023/A:1011983519823

Cite this article as:
Miedema, B.W., Schwab, J., Burgess, S.V. et al. Dig Dis Sci (2001) 46: 2250. doi:10.1023/A:1011983519823

Abstract

Postoperative nutrition is best provided enterally; however, patients often develop intolerance to enteral feedings. Our aim was to prospectively identify abdominal examination and jejunal pressure activity associated with postoperative intolerance of enteral feedings. Twenty-nine patients underwent abdominal operation and needle catheter jejunostomy placement. Elemental tube feedings were started on the day after surgery and advanced to the caloric goal rate over three days. Patients whose feedings were slowed at the attending surgeon's discretion were defined as intolerant. Jejunal manometry and a standardized abdominal exam were performed on postoperative days 1, 3, and 5. Fifteen patients (52%) were intolerant of tube feedings and had decreased jejunal motor activity but more active bowel sounds prior to feedings. After feedings, intolerant patients developed abdominal distension, but other abdominal findings were inconsistent. A marked decrease in phase II of the migrating motility complex (MMC) and the lack of a fed response were present in both groups. The overall jejunal motility present on day 1 following surgery identifies patients that will not tolerate enteral feedings. The abdominal examination, MMC parameters, and motor response to feeding did not predict feeding intolerance.

enteral feeding gastrointestinal motility intestinal disease jejunum nutrition surgery 

Copyright information

© Plenum Publishing Corporation 2001

Authors and Affiliations

  • Brent W. Miedema
    • 1
  • Jeffrey Schwab
    • 1
  • Scott V. Burgess
    • 1
  • James W. Simmons
    • 1
  • Michael H. Metzler
    • 1
  1. 1.Departments of SurgeryUniversity of Missouri Medical Center and Harry S. Truman Veterans Administration HospitalColumbiaUSA